Effective Drug Prevention: Sue Thau ADA’s ommunity Public ... · Marijuana Alcohol Cigarettes Northland Coalition Kansas City, MO Tri-County 8th Grade Students Past 30-Day Use of

Building Safe, Healthy, and Drug Free Communities Building Safe, Healthy, and Drug Free Communities

Sue Thau

Public Policy Consultant

CADCA

www.cadca.org

Effective Drug Prevention: CADCA’s Community

Coalition Model

http://www.cadca.org/

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CADCA History and Overview

• Founded in 1992 as a recommendation from the President’s Drug Advisory Council

• Today, CADCA supports a comprehensive, data-driven approach to prevent the use of illicit drugs, underage drinking, youth tobacco use, and the abuse of medicines

• CADCA represents more than 5,000 community coalitions • CADCA’s Vision

– A world of safe, healthy, and drug-free communities

• CADCA’s Mission – To strengthen the capacity of community coalitions to create and maintain

safe, healthy, and drug-free communities globally

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Conceptual Model for Community Coalition-Based Substance Use

Prevention: Social-Ecological Model

• Bronfenbrenner (1979)

• Ecological levels of analysis

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Social-Ecological Model

Macrosystems

Localities

Organizations

Microsystems

Individuals

• Individuals are nested within broader contexts that play a critical role in their health and well-being and impact their attitudes and behaviors.

• The web of connections that surround individuals necessitates interventions at all of these levels.

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What are coalitions?

A coalition is a formal arrangement for cooperation and collaboration between groups or sectors of the

community, in which each group retains its identity but all agree to work together towards a common goal of

building a safe, healthy, and drug-free community.

Coalitions Programs

Scale Coalitions measure success by examining community-level indicators. This applies to all coalition outcomes (short & long- term).

Programs measure change in individuals who have been directly affected by the intervention(s).

Addresses multiple causes Coalitions seek to ensure that all causes of identified problems are addressed

Programs are more focused on single strategies, e.g., parenting classes or peer mentoring.

Actors Coalition activities are diffused and taken by all members with staff playing a coordinating or supporting role.

Program staff lead the process and are responsible for implementing interventions.

Differences Between Coalitions and Programs

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Keys to Pushing Back Against Drug Use

• Taking a comprehensive, data-driven approach that appropriately mobilizes those who have a role in reducing access to and availability of drugs

• Changing social norms about the harms

that drug use can cause is also critical

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Key community sectors that all contribute to developing and carrying out strategies.

• Youth • Parents • Business • Media • Education • Public Health professionals/medical community • Youth serving agencies • Law Enforcement • Fraternal and religious organizations • Civic Organizations • Government Agencies • Substance Abuse organizations

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Basic Concept Coalitions bring together community

sectors to develop and carry out data-driven, evidence-based strategies to

achieve population-level reductions in substance abuse rates to include

underage drinking, tobacco use, illicit drug use, prescription drug and OTC

misuse and abuse

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Coalition Planning Process

Coalition initiatives seek to:

• Impact a specific, defined community.

• Engage all sectors and members of the entire

community/neighborhood.

• Address conditions and settings within the defined community.

• Promote comprehensive strategies.

• Achieve positive outcomes (reduce substance use/abuse rates) throughout the entire community/neighborhood.

Coalitions can drive community-level change

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“As the field of prevention has matured, it has been recognized that any single strategy is unlikely to succeed and a reinforcing set of strategies has the greatest potential to reduce use.”

Johnson et al., 2007

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The community coalition model, specifically the Drug-Free Communities program, has proven successful in reducing substance use/abuse

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The Drug-Free Communities Program (DFC)

• National program of federal grants directly to community coalitions to reduce youth substance use

• Grants go directly to community coalitions for 5 years

• US Government selects the grantees and CADCA provides their training

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The DFC Program Is Effective

• Recent evaluation data indicate that where DFC dollars are invested, youth substance use is lower.

– Over the life of the DFC program, youth living in DFC communities have experienced significant reductions in alcohol, tobacco, and marijuana use greater than national survey results.

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Types of Data DFC Coalitions Collect & Analyze

• Core metrics for the DFC Program – Past 30-day use, perception of harm, perception of parental

disapproval of use, and perception of peer disapproval of use for alcohol, tobacco, marijuana, and prescription drugs for three grades (6th-12th)

• But also – ER data related to ATOD issues

– Treatment admissions data

– Poison Control data

– Arrest data

– Vehicular crash data related to DUI and DUID

– Suspensions/expulsions from school related to ATOD

– High school graduation rates

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Percentage Decline in Use: First Report to Most Recent Report (2015)

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1. Provide information

2. Build skills

3. Provide social support

4. Change barriers and access

5. Change consequences / incentives

6. Alter the physical design of the environment

7. Change policy and rules

Environmentally-focused

Individually-focused

The 7 Types of Strategies Coalitions Implement

Source: KU Work Group for Community Health and Development, 2007

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Overview of Coalition Strategies to Address Prescription Drug Abuse

1. PROVIDE INFORMATION – Law enforcement partnerships to educate community members; PSAs and media campaigns; educating students; “lock it up” campaigns and community education; specifically reaching out to senior citizens to educate them on risks of Rx abuse

2. BUILD SKILLS – Partnering with doctors to educate them on risks of Rx abuse and get involved with prevention of “doctor shopping”; trainings to educate students, parents, and other stakeholders on how to prevent misuse of Rx drugs and identify warning signs of addiction

3. PROVIDE SOCIAL SUPPORT – Partnering with local pharmacies to distribute prescription drug warnings to raise awareness about the dangers of abuse

4. CHANGE BARRIERS AND ACCESS – Reducing barriers to proper medicine disposal by partnering with local law enforcement and other organizations to provide proper disposal of unused and expired medication

5. CHANGE CONSEQUENCES/INCENTIVES – Recognizing dentists who have received training on prescribing protocols and subsequently prescribe less than the full 30-day supply of pain medicine when treating adolescents who have their wisdom teeth removed

6. ALTER PHYSICAL DESIGN OF ENVIRONMENT – Take-back events, specifically designated days for mass collections to decrease access to unused, expired, or unwanted Rx drugs in homes; partnering with pharmacies/pharmacists to house an Rx drug drop-off box, provide resources on safe drug usage, storage, and disposal

7. CHANGE POLICY AND RULES – Work on local- and state-level legislation to implement effective Rx drug monitoring programs – Prescription Drug Monitoring Programs (PDMP)

STRATEGY

STRATEGY

STRATEGY

STRATEGY

STRATEGY

STRATEGY

STRATEGY

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In this DFC community, past 30 day non-medical use of prescription drugs decreased at a rate of 88.9% among 10th graders; 83.3% among 12th graders.

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12

3 3

1 2

0

2

4

6

8

10

12

14

10th Grade 12th Grade

Carter County Drug Task Force Grayson, KY

Past 30 day Non-Medical Use of Prescription Drugs Among 10th and 12th Graders

2004 2010 2012

Prescription Drug Abuse Results

Current DFC grantee, data from the Kentucky Incentives Project (KIP) Student Survey Instrument

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• Partnered with local law enforcement to implement take back events, installed permanent “drop boxes”, and increased DUI/drug suppression checks;

• Implemented a community-wide social norms media campaign;

• Designed and implemented “lock it up” campaign on the importance of proper storage of Rx drugs

• Provided educational opportunities with scale and scope throughout the community to parents, teachers, youth, pharmacists, and senior citizens

• Convened a key leader community forum to educate elected officials about the growing prescription drug problem and discussed strategies that could be adopted to address it

Strategies Implemented To Achieve Reductions

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In this DFC community, past 30 day use of alcohol decreased at a rate of 61.6%, from 50% in 2009 to 19.2% in 2013; and past 30 day use of marijuana decreased at a rate of 29.4%, from

35.4% in 2009 to 25% in 2013

50,0%

35,4%

19,2%

25,0%

0,00%

10,00%

20,00%

30,00%

40,00%

50,00%

60,00%

Alcohol Marijuana

Rio Arriba Family Care Network Espanola, NM

Past 30-Day Use of Select Substances among High School Students, 2009-2013

2009 2013

Underage Drinking and Marijuana Results

Graduated DFC grantee (from 2010-2015), data taken from Espanola Valley DFC Coalition Youth Survey and Rio Arriba County High School Questionnaire

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Example from CA: North Coastal Prevention Coalition

Graduated DFC grantee (from 1998-2009), data taken by coalition from California Healthy Kids Survey (CHKS) and project surveys administered to youth, adults, law enforcement, and others

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• Disseminated culturally-competent materials to educate the public about issues related to underage drinking

• conducted community wide education campaigns;

• conducted vendor and server training;

• conducted compliance checks;

• mobilized the community restrict youth access to alcohol;

• strengthened and enforced underage sales/service laws

Strategies Implemented To Achieve Underage Drinking Reductions

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In this DFC community, past 30 day use of marijuana decreased at a rate of 76.9%, from 13% in 2000 to 3% in 2010; past 30 day use of alcohol decreased at a rate of 66.7%, from 30% in 2000 to 10% in 2010; and past 30 day use of cigarettes decreased at a rate of 60%, from 15% in 2000 to

6% in 2010

13%

30%

15%

3%

10%

6%

0%

5%

10%

15%

20%

25%

30%

35%

Marijuana Alcohol Cigarettes

Northland Coalition Kansas City, MO

Tri-County 8th Grade Students Past 30-Day Use of Select Substances

2000 2010

Marijuana, Alcohol, and Cigarettes Results

Graduated DFC grantee (from 2006-2011), data taken from Missouri Student Survey

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• Partnered with local law enforcement to conduct compliance checks for alcohol, tobacco, and synthetic marijuana

• Proposed and implemented multi-media strategies

• Worked with coalition youth to develop and film a statewide PSA on underage drinking

• Held forums to educate parents and senior citizens on the dangers of youth drug and alcohol use

Strategies Implemented To Achieve Reductions

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Evaluation of CADCA’s Model to Build Effective Community Coalitions

• External Evaluation Team

– Michigan State University

– Led by Dr. Pennie Foster-Fishman

• Conducted annually since 2003

• Mixed Methods Approach

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Summary of Evaluation Findings for CADCA’s Trainings

• Training and Technical Assistance from CADCA help coalitions: – Develop their Capacity – Pursue Comprehensive Strategies – Promote Community Change

• The Framework for Change fits

urban/at-risk, suburban and rural coalitions.

• Coalitions get better in all elements of the CADCA community problem solving model.

• Training and Technical Assistance trigger a process of change that improves a coalition’s potential to achieve population level reductions in drug abuse rates.

1. Overall Capacity

2. Use of Comprehensive Strategies

3. Use of Environmental Strategies

4. Student perception of parental disapproval for using:

a. marijuana

b. tobacco

30 Day Use of Marijuana

Sig

nfi

can

t In

crea

ses

Sig

nifican

t Decreases

CADCA’s Institute Helps Coalitions Get Smarter Faster!

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CADCA’s International Programs At-A-Glance

• International Programs started in 2004.

• CADCA partners with the U.S.

Department of State, Bureau of

International Narcotics and Law

Enforcement Affairs (INL) and others in

its international work.

• Helps community leaders develop anti-

drug coalitions through training and

technical assistance to local non-

government organizations

in foreign countries.

• All trainings gear towards helping

communities achieve population-level

reductions in substance abuse rates.

Biscuiterie Community Coalition in Dakar, Senegal

Kwale Community Coalition in Kenya

Building Community Change Agents Globally

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Latin America and Caribbean:

Brazil, Bolivia, Colombia, Costa Rica,

Guatemala, Haiti, Honduras, Mexico, Peru, Uruguay

Africa:

Cape Verde, Ghana, Kenya, Senegal,

South Africa

Central Asia: Kyrgyzstan and Tajikistan

Asia Pacific: Philippines

Middle East: Iraq

Europe: Italy

CADCA’s International Programs

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Training in Manila, Philippines Training in Erbil, Iraq Training in Dakar, Senegal

Training in Santos, Brazil El Progreso Community Coalition in San Pedro Sula, Honduras


CADCA currently has resources in English, Spanish, Portuguese, Russian, French, Italian, and Arabic.

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UN Flag

United Nations headquarters in Vienna

CADCA delegation in Vienna, Austria

United Nations

• CADCA is an “NGO in Special Consultative Status” to the Economic and Social Council (ECOSOC) of the United Nations.

• CADCA is also an active member of the Vienna NGO Committee.

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• CADCA has a contract with the government of Italy to provide training and technical assistance.

• This contract calls for CADCA to work in two cities: Bologna and Naples

• In Bologna, CADCA worked with the University of Bologna, la Fondazione Duemilla, and the Casa del Populo Corazza.

• In Naples, CADCA worked with the Naples City Youth Programs Department and the Centro Hurtado.

Training in Bologna


Results from the Altavista Community Coalition, Ciudad Juarez, Mexico

• Partnered with local law enforcement to coordinate clean up operations in the park to ensure safety of volunteers and residents

• Implemented multi-media strategies on coalition efforts to close open air drug market and reopen the park to the public.

• Partnered with local government and businesses for necessary materials needed to restore the park

• Coalition members, youth and residents rehabilitated the park and installed a perimeter fence to lock the park at night.

• Established policies for conduct as well as hours of operation and posted signs throughout the park.

Strategies Implemented to Close Open Air Drug Market in the Park

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• Paulínia 85.2%

• Diadema 82.4%

• Pindamonhangaba 56.0% A poster in Portuguese discouraging the consumption of alcohol among

minors

Results from the Pindamonhangaba Community Coalition in Brazil

Research from the Federal University of São Paulo compared the sale of alcohol to minors in three cities in Brazil.

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Strategies Implemented Reduce Retail Access of Alcohol to Minors

• Disseminated materials to educate the public about the issues as well as the laws related to underage drinking

• conducted community wide education campaigns on the need to enforce existing laws on sale of alcohol to minors;

• trained merchants on underage sales/service laws as well as identification of minors at the point of sale;

• conducted compliance checks;

• mobilized the community to restrict youth access to alcohol;

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The Consortium of Anti-Drug Community Coalitions in Lima, Peru Coalition meeting

Evaluation Findings of the Community Coalition Initiative in Peru

From 2006 – 2011, community coalitions in Lima, Peru successfully targeted illicit drug use and crime.

• REDUCTIONS IN GANGS AND NEIGHBORHOOD CRIME

o Gang related problems (-32.9% reduction)

o Overall neighborhood crime (-6.7% reduction)

39 Source: PERU COALITION EVALUATION; Michigan State University and the University of Kansas, August 10, 2012.

Youth participating in a coalition

Police officer and coalition members raising awareness about existing laws

Evaluation Findings of the Community Coalition Initiative in Peru

REDUCTIONS IN DRUG USE AND ACCESS o Buying and selling of drugs in the

neighborhood (-25.1%) o Drug Use in neighborhoods (-10.5%)

REDUCTIONS IN ALCOHOL USE AND ACCESS o Minors’ Use of Alcohol (-52%) o Minors’ Access to Alcohol (-9.4%) o 18-24 year olds Use of Alcohol (-12.1%)

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CADCA Efforts on Marijuana Legalization

• CADCA strongly OPPOSES measures to legalize marijuana, and educates our grassroots members about the impact of such policies on public health and public safety; and

• CADCA coalitions in states that have already legalized marijuana for recreational purposes are on the front lines of monitoring the impact of these policies and sharing them widely

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Marijuana Use by State Policy

Source: 2016 Rocky Mountain HIDTA Report on Legalization of Marijuana in Colorado: http://www.rmhidta.org/html/FINAL%20NSDUH%20Results-%20Jan%202016%20Release.pdf

http://www.rmhidta.org/html/FINAL NSDUH Results- Jan 2016 Release.pdf




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Impact of Marijuana Legalization in Colorado






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Source: 2016 Rocky Mountain HIDTA Report on Legalization of Marijuana in Colorado: http://www.rmhidta.org/html/FINAL%20NSDUH%20Results-%20Jan%202016%20Release.pdf (graph from https://learnaboutsam.org/wp-content/uploads/2016/02/SAM-report-on-CO-and-WA-issued-17-February-2016.pdf)





https://learnaboutsam.org/wp-content/uploads/2016/02/SAM-report-on-CO-and-WA-issued-17-February-2016.pdf






















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Graph from https://learnaboutsam.org/wp-content/uploads/2016/02/SAM-report-on-CO-and-WA-issued-17-February-2016.pdf

Marijuana-Related Impaired Driving Cases Have Spiked in Colorado After Legalization























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Marijuana-Related Poisonings in Colorado Surged after Legalization























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Youth Treatment Admissions for Marijuana Use in Colorado Increased after Legalization























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Expanding Advertising in Colorado

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Edibles for Sale in Colorado

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Types of Marijuana

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CADCA 625 Slaters Lane, Suite 300 Alexandria, Virginia 22314 United States of America

1-703-706-0560

www.cadca.org www.facebook.com/CADCA

@CADCA [email protected]

http://www.cadca.org/

http://www.facebook.com/CADCA

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Documents

Effective Drug Prevention: Sue Thau ADA’s ommunity Public ... · Marijuana Alcohol Cigarettes Northland Coalition Kansas City, MO Tri-County 8th Grade Students Past 30-Day Use of